The Daily Sceptic’s in-house doctor – formerly employed by the NHS, now in private practice – has written a guest post about a recent Policy Exchange report on how the NHS should manage its huge waiting list. He isn’t impressed.
Last week, the think tank Policy Exchange published a report entitled: “A wait on your mind – a realistic proposal for tackling the elective backlog.”
I’m very grateful to the authors, because I love a good chuckle, and this banal document had me laughing out loud at several points. There is so much in it, I barely know where to start – this article can only scratch the surface. It commits the cardinal sin of most NHS ‘strategy documents’ effectively being a wish list for a healthcare utopia – oblivious to the obvious fact that in a world of limited resources, one cannot be strong everywhere.
Readers may not be aware of how or why such reports are constructed. As with all medical/scientific publishing, it’s important to understand the process of production to uncover the real purpose and message. I have contributed to several similar documents over the years. The starting point is normally a specific agenda that the report’s funders wish to push – this isn’t always obvious, although an informed audience can read between the lines. I note that this report was “supported by research grants provided by Ramsay Health Care UK, Smith + Nephew and the Independent Healthcare Provider Network (IHPN)”. Readers can probably figure out the agenda for themselves.
The ‘evidence’ for the report is generally acquired by selecting a compliant group of ‘experts’ that can be relied on to provide the correct opinions. The experts are gathered together with plenty of tea and biscuits – or a couple of cases of wine for a more revealing discussion.
Once the experts have sounded off from their particular perspectives, the writers craft the comments into a narrative. The language is usually verbose in style containing pages of pointless verbiage calculated to dress up the work as deeply researched and referenced. On closer inspection many of the ‘references’ are linked to other opinion pieces that conveniently chime with the predetermined purpose. Reliable ‘elder statesmen’ write a preface and a forward to create an illusion of gravitas and authority. Various other lesser figures in prominent medico-political positions are co-opted for endorsements.
The report is then touted around decision makers and passed off as a representation of current thinking. Successful documents provide decision makers with intellectual cover for controversial changes they want to make anyway. In some ways it’s a bit like employing management consultants – they are paid to tell policy makers what they want to hear, and to take the blame if the decision goes sour.